• World Neurosurg · Dec 2015

    Case Reports

    Primary cerebellar Gliosarcoma with extra-cranial metastases: An orphan differential diagnosis.

    • Atef Ben Nsir, Quoc-Anh Thai, Alia Zhani Kassar, Imed Ben Said, and Hafedh Jemel.
    • Department of Neurosurgery, Fattouma Bourguiba University Hospital-University of Medicine of Monastir, Monastir, Tunisia. Electronic address: atefbn@hotmail.fr.
    • World Neurosurg. 2015 Dec 1;84(6):2076.e13-7.

    BackgroundGliosarcomas are rare, malignant primary brain tumors, most commonly located in the temporal lobe, that contain both glial and mesenchymal elements. Gliosarcomas located within the cerebellum are exceedingly rare. The previously unreported finding of a cerebellar gliosarcoma concurrently with an extracranial metastasis to the lungs is discussed here.Case DescriptionA 57-year-old man presented with a 3-month history of chest pain, weight loss, headaches, and vomiting. Physical examination revealed a left cerebellar dysfunction, and the radiological work-up revealed a 6 × 6-cm right apical pulmonary tumor and a 4 × 3.5 × 3.8-cm peripherally enhancing left cerebellar mass. On the basis of a smoking history in the setting of a lung lesion and cerebellar mass, the presumptive diagnosis was primary lung cancer with metastasis to the cerebellum. Gross total resection of a firm pseudo-encapsulated cerebellar mass was performed. The microscopic features and the immunohistochemical profile confirmed the diagnosis of Gliosarcoma. The thoracic lesion was removed subsequently, and pathology confirmed it as an extracranial metastasis from the cerebellar gliosarcoma. Adjuvant radiation and chemotherapy were then administered. No clinical or radiographic evidence of recurrence was observed during one year of follow-up monitoring.ConclusionsTo the best of our knowledge, a primary infratentorial gliosarcoma with extracranial metastases has not been previously described.Copyright © 2015 Elsevier Inc. All rights reserved.

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